Causes

The brown patches are due to an increased amount of melanin in the skin. The exact cause of increase in melanin is unknown. It is thought to be associated with hormones such as estrogen and progesterone. Sun exposure also plays a major role.

Risk Factors

Melasma is more common in women during their reproductive years, but it can occur in men. Other factors that increase may your chance of melasma include:

Family history of melasma

Having a darker skin tone

Pregnancy

Getting too much sun exposure

Taking birth control pills

Using products that irritate the skin, such as cosmetics

Certain medications, such as antiseizure drugs or hormone therapy

Symptoms

The only sign of melasma is dark patches of skin. It is not painful or itchy.

Not all brown patches on your skin are melasma. Talk to your doctor about changes in your skin.

Diagnosis

You will be asked about your symptoms and medical history. Your skin will be examined. A lamp, called a Wood’s lamp, may be used to look at your skin. A small sample of skin may be taken for a biopsy. The sample will be sent to a lab to confirm the diagnosis.

Treatment

Melasma may go away on its own. If it does not go away, it may need to be treated. In general, treating melasma can be difficult. Talk with your doctor about the best treatment plan for you.

Removing Cause

Factors that are causing the melasma may be removed. For example:

Melasma associated with pregnancy may slowly fade after giving birth.

Melasma associated with birth control pills or hormone replacement therapy may fade after the medication is stopped.

Melasma can reappear and become darker if you become pregnant again or resume taking medication.

Avoid using products that can irritate your skin. These include make-up, creams, and cleansers.

Ultraviolet Light Protection

Protecting your skin from UV light is important in helping to fade melasma. This means avoiding sun and tanning bed exposure. Your doctor may advise wearing sunscreen, clothing, and hats when outdoors.

Depigmenting Medications

Certain medications, like bleaching creams, are used to lighten skin color. A common bleaching cream used to treat melasma is
hydroquinone. This may also be used with other creams or combination of creams such as
tretinoin, corticosteroids,
azelaic acid,
or glycolic acid. These creams enhance the skin-lightening effect.

Your skin may be sensitive to these medications. Use care and start slowly when first using them. It may take several months before you see an improvement.

Other Treatments

Other treatments remove outer layers of the skin. These include:

Chemical peel

Microdermabrasion—removing top layer of skin

Laser therapy

Prevention

To help reduce your chance of getting melasma:

Limit the amount of time you spend in the sun. Avoid using tanning booths.

Use sunscreen daily. Wear sunscreen that protects against both UVA and UVB rays and has an SPF of 30 or more.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.